Annual Report 2008-09 - Austin Health

Acute Operations
Austin Health performed 21,000 surgical procedures in 2008-09, an 18 per cent
increase over last year. The highly-successful elective surgery model at
The Surgery Centre contributed to a surgical waiting list reduction of 22 per cent.
SPECIALTY
The Departments of
Cardiology and Cardiac
Surgery have initiated a clinical
program to replace narrowed aortic
valves using a new minimally-invasive
technique. The procedure can be
performed via the transfemoral
or transapical approach. The first
procedure at Austin Health was
performed in December via the
transapical approach and was
one of Australia’s first heart valve
replacements that did not involve
open-heart surgery. It involved inserting
a new type of pericardial heart valve,
constructed from cow tissue, via a
small incision between the ribs. The
procedure was guided via x-rays and
ultrasound to the aortic valve position.
The transfemoral technique follows
a similar principle except the valve is
inserted into the heart through a small
incision in the patient’s leg. The new
technique eliminates the need for a
heart-lung machine and reduces the
patient’s recovery time, which makes it
suitable for those at very high risk from
major cardiac valve surgery.
Assoc Prof George Matalanis pioneered
a technique to replace a patient’s aorta
while ensuring continuous blood flow
to the brain. In a 12-hour procedure,
Assoc Prof Matalanis re-routed the
arteries supplying blood to the patient’s
brain. The arteries were disconnected
one at a time, allowing two to provide
blood flow, until finally all three were
supplying blood from a bypass machine.
The technique enabled a quicker recovery
and eliminated the risks associated
with traditional deep cooling such as
the impairment of higher brain function.
To share the revolutionary method, the
surgery was broadcast from Austin
Hospital’s operating theatre to a
symposium of international surgeons
in Queensland.
A heart attack (myocardial infarction) is
a medical emergency and the patient
has no time to lose. Blood supply must
be restored to the heart urgently with a
miniature balloon and a stent. For every
15 minutes saved before the blocked
artery is cleared, there is a seven
per cent increase in patient survival.
Following last year’s pilot program,
the time lapse between ST segment
elevation myocardial infarction (or STEMI)
patients presenting at ED and receiving
treatment has been cut by 43 minutes.
The mean time for treatment is now 73
minutes, well below the best-practice
target of 90 minutes. A multidisciplinary
team from ED, Cardiac Catheterisation
Laboratory and the Cardiac and Thoracic
Ward have continued to seek ways to
shave off precious minutes. The staff
have now partnered with Ambulance
Victoria to introduce direct admission to
the Cardiac Catheterisation Laboratory
from the ambulance, expected to provide
an even greater reduction in ‘door to
balloon’ times.
The Cardiology Department benefitted
from DHS’ Targeted Equipment
Program funding to upgrade two cardiac
ultrasound machines with state-of-theart
replacements. Valued at $800,000, the
high-volume machines offer 3D and 4D
scanning capability to analyse the health
of a patient’s heart. With 7,000 scans
carried out annually, staff appreciate the
advanced ergonomics of the equipment.
Tragically, the highly-esteemed
Prof-Director of Respiratory and
Sleep Medicine, Robert Pierce, died
in Victoria’s bushfires on Saturday 7
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Austin Health : 2008-09 ANNUAL REPORT